Diagnostic utility of a second minor salivary gland biopsy in patients with suspected Sjögren's syndrome: A retrospective cohort study - 15/01/23
Highlights |
• | Concordance between repeated minor salivary gland biopsies is low. |
• | Second salivary gland biopsy influences diagnosis when guided by clinical evolution. |
• | MSGB should be repeated if lymphoma, amyloidosis or sarcoidosis is suspected. |
Abstract |
Objective |
To determine whether repeated minor salivary gland biopsy (MSGB) has a clinical diagnostic utility in patients with suspicion of Sjögren's syndrome (SS).
Methods |
Clinical, biological, pathological data and physician's diagnosis after each MSGB from patients with suspected primary or secondary SS who had benefited from 2 MSGB at Brest University Hospital between January 1st, 1990 and January 14th, 2015, were retrospectively collected. We compared the characteristics of patients with and without first positive MSGB, concordance between the MSGB, and analyzed the modifications of diagnosis after the second MSGB.
Results |
Ninety-three patients were included, first MSGB was positive for 23 and negative for 70. Patients with first positive MSGB had more often renal involvement (P<0.05) and hypergammaglobulinemia (P=0.01), anti-SSA antibodies (P<0.05) and positive second biopsy with focus score ≥ 1 or Chisholm>2 (P<0.01). The mean time between the 2 MSGB was 5.7±4.3 years. The concordance between the results of the 2 biopsies was low (κ = 0.34). MSGB influenced diagnostic's change in 10 cases where the second MSGB was always guided by new specific clinical manifestations.
Conclusion |
We observed a low concordance between 2 MSGB in patients with suspected pSS in our study. Despite this variability, performing a second MSGB changed the initial diagnosis in only a minority of the patients and was particularly useful when clinical manifestations had deeply evolved.
Le texte complet de cet article est disponible en PDF.Keywords : Sjögren's syndrome, Minor salivary gland biopsy, Diagnosis
Plan
Vol 90 - N° 1
Article 105459- janvier 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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